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Effect on Small Airways in Poorly Controlled Asthma: QVAR® Outdistances Fluticasone

QVAR Significantly Decreases Air Trapping (CV/VC) and Improves Small-Airway Function (FEF25%-75%) But Fluticasone Does Not3
         
  • Standard lung function tests (eg, FEV1 and PEF) do not measure small-airway obstruction1
  • Increased closing volume (CV) and air trapping reflect small-airway obstruction3,4
  • QVAR, when added to existing therapy, significantly decreased closing volume to vital capacity ratio (CV/VC),
          demonstrating reduced air trapping, and improved small-airway function3

  • The mean change in CV/VC from baseline decreased significantly more in the QVAR group than in the
          fluticasone group (P=0.0194)3
  • QVAR significantly improved prebronchodilator and postbronchodilator percent of predicted forced expiratory
          volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of vital capacity (FEF25%-75%),
          postbronchodilator residual volume, daily albuterol use, morning peak expiratory flow, and phlegm symptoms3
  • No significant improvements were seen in the fluticasone group (FEV1, FEF25%-75%, CV/VC, and daily albuterol
          use)3
QVAR® Improves Mid-Expiratory Flow FEF25%-75% vs Fluticasone3
         
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    References:
  1. Martin RJ. Therapeutic significance of distal airway inflammation in asthma. J Allergy Clin Immunol. 2002;109(2):S447-S460.
  2. Yanai M, Sekizawa K, Ohrui T, et al. Site of airway obstruction in pulmonary disease: direct measurement of intrabronchial pressure. J Appl Physiol. 1992;72:1016-1023.
  3. Thongngarm T, Silkoff PE, Kossack WS, Nelson HS. Hydrofluoroalkane-134A beclomethasone or chlorofluorocarbon fluticasone: effect on small airways in poorly controlled asthma. J Asthma. 2005;42:257-263.
  4. Zeidler M, Corren J. Hydrofluoroalkane formulations of inhaled corticosteroids for the treatment of asthma. Treat Respir Med. 2004;3(1):35-44.
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